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Tabitha Marie Long
Student in an Organized Health Care Education/Training Program in Kenosha, Wisconsin
NPI 1417411620

Tabitha Marie Long is a Student in an Organized Health Care Education/Training Program based in Kingston, WI. Tabitha Marie Long practices in Kenosha, WI. The NPI Number for Tabitha Marie Long is 1417411620 and holds a License No. (Wisconsin).

The current practice location address for Tabitha Marie Long is 2001 Alford Park Dr, Kenosha, WI and can be reached out via phone at 262-551-8500. You can also correspond with Tabitha Marie Long through the mailing address at 249 MAIN ST, KINGSTON, IL - 60145-6800 (mailing address contact number: 815-218-4924).

Location: 2001 Alford Park Dr, Kenosha, WI, 60145-6800
Profile Details Legacy Identifiers Practice Address Mailing Address Primary Taxonomy
person
Provider Profile Details
NPI Number
1417411620
Provider Name
Tabitha Marie Long
Credential
Provider Entity Type
Individual
Gender
Female
Address
2001 Alford Park Dr, Kenosha, WI, 60145-6800
Phone Number
262-551-8500
Fax Number
Provider Enumeration Date
01/22/2019
Last Update Date
03/10/2024
institution
Provider Business Practice Location Address Details
Address
2001 Alford Park Dr
City
Kenosha
State
Wisconsin
Zip
53140-1927
Phone Number
262-551-8500
Fax Number
person
Provider Business Mailing Address Details
Address
2001 Alford Park Dr
City
Kenosha
State
Wisconsin
Zip
53140-1927
Phone Number
262-551-8500
Fax Number
person
Provider's Taxonomy Details 1
Type
Student, Health Care
Classification
Student in an Organized Health Care Education/Training Program
Speciality
-
Taxonomy
390200000X
License No.
()
Definition
An individual who is enrolled in an organized health care education/training program leading to a degree, certification, registration, and/or licensure to provide health care.
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